When treating breast cancer patients with RNI, how often do you include internal mammary nodes?

Treating the internal mammary nodes (IMNs) increases heart and lung exposure; hence, the value of prophylactic IMN RT has been controversial for decades. Randomized trials suggest there may be some benefit to such treatment but disagree on which patient subgroups benefit most or not at all.

A trial c...

We try to include for all but the threshold for under coverage or to skip IM coverage is low if dosimetric constraints are harder to meet, especially for 1 to 3 nodes and outer quadrant disease.